Individual
SHANTELL TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
371 HOLLY GLENN, MONROE, MI 48161-5762
(734) 777-7361
Mailing address
371 HOLLY GLENN, MONROE, MI 48161-5762
(737) 777-7361
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703098903
MI
Other
Enumeration date
08/13/2015
Last updated
08/13/2015
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